Tough Lessons
by Sarcasticles
Summary: It was something every doctor went through; not ever patient could be saved. Not every patient wanted to be saved. Chopper would learn that, or he would tear himself apart in grief and guilt.


Dr. Kureha adjusted the sunglasses over her eyes. Today the sun's reflection was especially bright on the snow, promising snow blindness to anyone caught unawares. By her side Chopper gave himself a quick shake. They had trudged down from her home to the edge of Bighorn village, and little bits of snow and ice had gotten in his fur.

The snow crunched underfoot as the pair made their way to a small house. A heavily bundled woman was already waiting for them by the door. Kureha gestured for Chopper to wait, before walking up to the woman.

"Florence, it's been too long." Kureha said as she took a swig from her bottle.

The woman's face was grim. "Thanks for coming out. I know this is risky for you." She said in a low voice.

"As if our idiot king could keep me away. Now, what seems to be the problem?"

"You had best see for yourself. It's…it's not good." Florence replied; her voice strained.

Kureha frowned the smallest of frowns before whistling Chopper over. The boy, in his full reindeer form, trotted over. Florence gave him an odd look, but recovered quickly.

Florence knocked on the door. Without waiting for a reply, she opened it up and let them all come into the small one room house. An immense fire blazed, and the heat was stifling. Chopper shuddered, but did not change shape. Kureha shucked off her coat and scanned the room for her patient.

He was easy to find. A bed stacked high with blankets was tucked away in one of the corners. Kureha could barely see a stock of fuzzy white hair that stuck out of the blankets. Even from across the room she could hear his breath rattle in his chest.

"Come along Chopper." She said in a clipped voice. He gave a small grunt and went over to the man, his hooves softly clopping across the floor.

"Markus? I'm Dr. Kureha, how are you feeling?" Markus rasped something that almost sounded like 'go to hell'. Kureha ignored the sentiment, and rolled back the blankets.

Despite the heat, Markus was shaking. His clothes were drenched with perspiration, and his face was pale. A wet sounding cough shook through the old man's body. Both his nail beds and lips were tinged blue.

Lips pursed, Kureha looked back at Florence. "How long has this been going on?"

The other woman sighed, "I try and come once a week, to help around the house, but with everything going on I haven't been over since the seventeenth."

The seventeenth was two and a half weeks ago. Scratching her head, Kureha glanced down at Chopper. The reindeer looked back with open expectation. "Watch how I do this, I'll test you later." She said. He nodded his understanding and took another half step closer.

Carefully Kureha helped Markus to a sitting position. She adjusted the blankets around him and began her assessment. Unsurprisingly he had tachypnea and tachycardia and his lung sounds were coarse. Bilateral peripheral pulses were weak and thready, and he was running a fever.

As Kureha went to lift up Markus's shirt he began to fight her, "Damn it all woman! Unhand me!" he demanded weakly before breaking out into another round of coughing. She pressed a cloth up to his face until it ran its course. When he finished she glanced at the blood-tinged mucus he had managed to hack up before folding the cloth up and setting it aside.

Florence was suddenly by their side, kneeling by the gasping man. "Markus, Dr. Kureha is here to help you. You need to let her assess you." She urged.

"Like hell I need that damn sellout to touch me. Damn it; just let me alone!"

"Markus, Kureha doesn't work for Wapol anymore than Ian did." Florence said gently.

"Bullshit," he rasped, "The bastard got rid of all dumbasses who wouldn't submit."

"Markus!" Florence said sharply, "You remember Kureha; she helped Melville when she was pregnant with Ian. Now let her look you over!" Kureha didn't know if Markus understood what Florence was saying or if he was simply too exhausted to fight, but he stopped struggling and allowed Kureha to lift up his shirt.

With deft hands Kureha percussed over his lung fields. The sounds she heard confirmed her worst suspicions. "He has a considerable amount of fluid in the bases of his lungs." She said sadly. Florence nodded in understanding, and gently they laid him back down and recovered him with his blankets.

"Will you give me a minute?" Kureha asked.

"Sure, you're the doctor." Florence replied. Kureha quickly put her coat back on and gestured for Chopper to join her outside. Florence was a grounded woman, but Kureha suspected she wouldn't act favorably if her reindeer began to talk.

Outside, Chopper changed into his hybrid form. "He has pneumonia, doesn't he? I heard the dullness when you tapped his back, and he has all the other symptoms you had me read about." He said.

"It's called percussion Chopper, not tapping. And yes, Markus has the classic signs of pneumonia." Kureha replied.

"So what are you going to do? Amoxicillin? I think I read that it works well with most cases, although I think Azirithromycin is used sometimes too…" Chopper began excitedly.

"There are other things we have to consider here, Chopper."

"Like what?"

"Well, his age for one," Kureha pointed out.

"But he's younger than you!" Chopper exclaimed.

"That is beside the point! Not everyone has the knowledge or will to maintain their youth and beauty like I have."

"So we're not going to use Amoxicillin then?"

"Chopper, we're not going to use antibiotics at all." Kureha said softly.

"Well why not? We need to cure him so he can be better!" Chopper demanded.

Kureha felt her heart break a little. She could see too much of Hiliruk in Chopper. How could she explain something like this when he had just started learning real medicine? It might ruin him...But not teaching him this lesson now would be a disservice to Chopper. He simply had to learn.

"Markus isn't going to get better." Kureha said with as much gentleness as she could muster.

"You're lying!" Chopper shouted, "There's always a chance to get better. You…you just don't want to try! You just think it's too much effort!"

Kureha's eyebrows snapped together as she felt anger well up deep within her. "How _dare_…Tony Tony Chopper, don't you ever say such a thing!" she spat.

"Then why not?" Chopper cried.

"Because Markus _wants_ to die." Kureha said coldly. Chopper's breath hitched, and tears welled up in his eyes. Transforming into his full reindeer form as he turned, he ran towards the woods.

Kureha let him go. He was probably running back to the relative safety of her home, and she had a patient that needed treatment. Taking a deep breath Kureha calmed herself and reentered the house. Inside she saw the confused Florence, who was placing a cool cloth on Markus's head.

"Who was it you were talking to? And where'd your reindeer go?" she inquired.

Xxx

It was several hours before Kureha made it home. She was unsurprised to see Chopper sitting with several open books in front of him. He furiously went from page to page, scribbling down notes on a pad of paper. Every once in a while his breath would catch or he sniffled his nose.

"Chopper, we need to talk." Kureha said forcefully.

"No, not if you're going to let people die. I'll just learn by myself, I don't need your stupid help!"

"Quit acting like a child. You and I will have this conversation or you will cease to be my student."

"I don't care!"

"I only open my house to students," Kureha minded him, "We will talk, or I will kick you out." The words were cruel, but necessary. Reluctantly Chopper turned to face her. His drew his hat as far down his face that he could without actually covering up his eyes and sat with his arms crossed. Kureha sighed and pulled up a chair.

"Several years ago Markus's wife, Melville, passed away," she began, "He was heartbroken, and never really recovered." Chopper looked up at her in confusion, but Kureha raised her hand for silence, "The only thing he had left in the world was his son, Ian. Ian is…was…a doctor."

Chopper gasped, "Is he one of the Isshi-20?"

"No. Ian refused to buckle to Wapol's demands. He was executed with several others last year."

"That's horrible!"

"Yes, but that's the king's law. Anyway, Florence was the secretary for Ian's practice. After Ian's death Markus holed himself in his house and refused to come out; she made sure he had food, firewood, and the like. But Markus never came out of his depression, and it reflected in his health. He gave up."

Tears rolled down Chopper's face, "But…But that's not fair! We should be able to heal him!"

"Medicine is hardly ever fair. It's true that we could treat his pneumonia, although even that would be a long shot, but it's his heart that's sick. We can't fix that. I'm sorry, but that's part of being a doctor." Kureha said as kindly as she could. However, kindness wasn't her expertise, and the words came out more bitterly than she intended.

"There's nothing we can do?" Chopper whispered.

"We'll give comfort cares only. There's no reason for anyone to spend their last days in pain and suffering if we can do anything about it. Now, I did a more complete assessment after you left," Chopper flinched when she mentioned his running away. She ignored it, "And had a talk with Florence. I've got a plan of care figured out; we'll go back tomorrow and make sure nothing else happens. Do you understand Chopper?"

"Yes, Doctorine." He said quietly. Kureha could still tell that he was very upset, but there was nothing she could do to help. It was something every doctor went through; not every patient could be saved. Not every patient _wanted _to be saved. Chopper would learn to accept it, or he would tear himself apart in grief and guilt.

"Good. Now I'm going to go over everything with you so you'll be ready in the morning." She said.

Xxx

The next four days were the most difficult of Chopper's young career. Kureha watched as he struggled to accept the inevitable. To his credit, he preformed his tasks gamely and without complaint.

They worked in tandem with Florence. Over the days she grew accustomed to Chopper to the point where she was comfortable watching him transform. She too was struggling with grief. Having been a friend of the family for quite some time; watching Markus go through the process of dying was difficult.

Kureha's own sorrow was muted by over a century's worth of experience. She had seen hundreds go through the same process as Markus. As his breathing became shallower and his lucid moments less frequent, Kureha knew that he had found his peace.

It was nearly midnight on the fourth day when Markus passed. Gently Kureha shook Chopper and Florence awake for his last moments. He took a final breath before an unnatural stillness overtook his body. Respectfully Kureha closed his eyes, and beside her Florence softly prayed.

Chopper clutched one of her legs and began crying. "I'm going to do it." He said through shaky breaths.

"Do what?" Kureha asked.

"I'm going to learn how to heal everything. Just because we don't know how to fix broken hearts doesn't mean that a cure isn't out there. I just have to find it." Kureha didn't answer, but reached down and patted his back.

Time and again she thought that Chopper had too much Hiliruk in him. The crazy quack had somehow managed to ingrain his foolish ideology into the poor, impressionable reindeer so deeply that she wasn't sure she could beat it all out of him.

It reminded Kureha of her younger days, before one hundred years of practice had worn out all the hope. Yet Kureha couldn't quite bring herself to dissuade him completely. Despite the fact that she had just began to teach him, Kureha considered him the son she never had.

Maybe she could balance him, give him the best of both his parents. With Hiliruk's drive and her knowledge it might be possible to heal even the most broken of individuals.

"I'm sure Hiliruk would be proud of such a dream." She finally said. Chopper looked up at her through the tears and nodded emphatically, his silent promise to be the best doctor he could be.

Xxx

AN: Back in ye olde days before X-Ray percussion (the technique that a lot of practitioners still use when they thump their fingers on you) was used to find lung and abdominal tumors, and can be used to test for fluid buildup in the lungs; as well as liver, kidney, heart, and spleen placement/positioning. There are also several other easy tests that can be done over the lung fields, based on the fact that sound travels better through a solid mass/fluid than it does through air.

If you feel so inclined, a review would be appreciated.


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